How it works

1. Free initial consultation

Answer some questions about your mental health, 100% online.

1. Free initial consultation

Answer some questions about your mental health, 100% online.

2. Expert assessment

A medical professional will determine the right treatment for you based on the information you provide.

2. Expert assessment

A medical professional will determine the right treatment for you based on the information you provide.

3. Free delivery

Your treatment ships to you for free, if prescribed.

3. Free delivery

Your treatment ships to you for free, if prescribed.

4. Ongoing support

Get unlimited access to follow-ups, adjustments, refill updates, and answers to your questions throughout your treatment.

4. Ongoing support

Get unlimited access to follow-ups, adjustments, refill updates, and answers to your questions throughout your treatment.

Anxiety & depression
medication

Start a free initial assessment to see if doctor-trusted mental health treatments might be right for you.

Balance Blend Rx

SSRI ingredient + supplements

 

Important safety information

Generic for Lexapro®

Escitalopram

 

Important safety information

Generic for Zoloft®

Sertraline

 

Important safety information

Generic for Wellbutrin XL®

Bupropion XL

 

Important safety information

Generic for Prozac®

Fluoxetine

 

Important safety information

Generic for Buspar®

Buspirone HCI

 

Important safety information

Generic for Celexa®

Citalopram

 

Important safety information

Generic for Effexor®

Venlafaxine

 

Important safety information

Generic for Cymbalta®

Duloxetine

 

Important safety information

Prescription products require an online consultation with a healthcare provider who will determine if a prescription is appropriate. The featured products include compounded drugs that have not been approved by the FDA. The FDA does not verify compounded drugs' safety, effectiveness, or quality.

Personalized support
that fits your needs

Anxiety, stress,
and worry

Inability to relax, feeling on edge, or fearing the worst.

Anxiety, stress,
and worry

Inability to relax, feeling on edge, or fearing the worst.

Start assessment

Lack of
motivation

Hard to concentrate, constant fatigue, or burnout.

Lack of
motivation

Hard to concentrate, constant fatigue, or burnout.

Start assessment

Sadness, grief,
and loss

Exhaustion, despair, or difficulty with normal tasks.

Sadness, grief,
and loss

Exhaustion, despair, or difficulty with normal tasks.

Start assessment

Trouble sleeping

Racing thoughts that interrupt sleep or rest.

Trouble sleeping

Racing thoughts that interrupt sleep or rest.

Start assessment


What to expect

Medication takes time to do its job, and everybody is different. That's why we start you on a smaller introductory dose, to give your system time to adjust. This is psychiatry, personalized.

A provider will help you find a personalized treatment plan, including medication adjustments if needed for no additional cost.

Start with an introductory dose to help get your body accustomed to medication. Increase to a full dose with provider guidance.

Get support every step of the way with unlimited provider messaging and private check-ins.

Featured reviews

Feel-good results

Feel-good results

Elizabeth S.

“I could get the help I needed on my own time when the kids are asleep! I'm finally the mom I want to be.”

Verified review

Andrea, 27

“It was easier and more affordable than I ever imagined to get my medication.”

Verified review

Seraina

“In the comfort of my pj’s, I was asked a series of questions and was immediately provided with resources.”

Verified review

Megan M.

“I hit a bottom and Hers was just what I needed. I didn’t have to worry about making an appointment or going to a doctor's office.”


Verified review

Laylla

“I decided to seek treatment through Hers, and I was relieved to find the support I needed and medication that works for me.”

Verified review

Devan, 29

“My medication came straight to my mailbox without me having to wait in long pharmacy lines or the doctor’s office.”

Verified review

Mary, 23

“I am now stress-free from doctor appointments, co-pays, and letdowns. This is your sign to take the step with Hers.”

Verified review

Meghan, 27

“Working with my healthcare provider has given me a sense of relief. I can reach out on the Hers app for support and questions with no judgment.”


Verified review

* Paid testimonials. Customers' results have not been independently verified. Individual results will vary.

Felt better

Over 75% of Hers customers who checked in with their provider reported improvements in their mental health symptoms.*

* Results vary. Data were self-reported between 11/26/2021 and 08/01/2022 by Hers customers who 1) signed up between 11/04/2021 and 05/04/2022; 2) were prescribed…Read more

A team you can trust

Our board-licensed psychiatry providers have years of experience and undergo a rigorous vetting process before they’re added to our network, so they’re ready to help with whatever you’re going through.

More for your mind

Learn about dealing with everything from relationship issues to burnout.

Hypnosis for Anxiety:
Is It Effective?

A Guide to Finding a Therapist

FAQs about anxiety and depression medication
Pricing for our telehealth mental health services is cost-effective starting at $49/month. No insurance is required, so there are no complicated insurance questions or health insurance plan considerations.
We offer access to online psychiatric services for a variety of conditions, such as anxiety disorders, depression, issues with burnout, stress, and major life events and changes.

We are committed to delivering holistic, quality care virtually with our telepsychiatry options.

Note: we do not treat certain mental illnesses, such as bipolar disorder, schizophrenia, OCD or ADHD.

Currently, providers on our platform do not prescribe controlled substances (eg, benzodiazepines, klonopin, etc.) for psychiatric care. Instead, the mental health provider you work with on our platform will review symptoms of anxiety or depression, your medical history, and other information to determine the best psychiatric medication among a range we offer.
You will answer questions about mental health and provide information about your medical history and physical symptoms to a medical provider. The provider will be an online doctor or nurse practitioner who can determine if medication or other options are right for you (such as psychotherapy, referral, etc). These mental health professionals will then share the information with you so you can make an informed decision on treatment options.
Most medications have the potential for side effects, some more than others. Potential side effects from selective serotonin reuptake inhibitors (SSRIs) and other psychiatry medications on our platform are listed on our website under important safety information on each medication page among other places. Always feel free to ask a provider about side effects prior to or during treatment.

Get the most out of
your care

Get the most out of your care

Explore curated mental health content
Manage and track orders
Get 24/7 live support

Get the
Hers app

741-741

If you're in emotional distress, text HOME to 741-741 to connect with a Crisis Text Line counselor immediately.

911

If you’re having a medical or mental health emergency, call 911 or go to your local ER.

Important Safety Information

The information below includes important safety information about bupropion ER XL, which is the generic version of the brand name drug Wellbutrin® XL. Read this information before you begin taking bupropion ER XL. You must notify your healthcare provider if you start or stop taking bupropion ER XL.
Bupropion ER XL (bupropion hydrochloride) is a prescription medicine used to treat major depressive disorder (MDD), seasonal affective disorder (SAD), and to help people quit smoking (smoking cessation). Bupropion may also be helpful when prescribed “off-label” for bipolar disorder, attention deficit hyperactivity disorder (ADHD), and sexual dysfunction due to SSRI antidepressants.

WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Bupropion ER XL and other antidepressant medicines may increase suicidal thoughts or actions, in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. Watch for these changes and inform your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Pay particular attention to such changes when bupropion ER XL is started or when the dose is changed.

Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.
Do not take bupropion ER XL (bupropion hydrochloride) if you:
  • Are allergic to bupropion, as contained in bupropion hydrochloride, or any of the ingredients in bupropion
  • Take any medication for Parkinson’s Disease or depression called monoamine oxidase inhibitors (MAOI), or if you have stopped taking an MAOI in the last 14 days as they may cause a dangerous increase in blood pressure. MAOIs include, but are not limited to: isocarboxazid, phenelzine, rasagiline, selegiline, tranylcypromine
  • Are already taking a medication containing bupropion
  • Are taking tamoxifen
  • Have a recent (within 5 years) history of a seizure disorder
  • Have a history of anorexia nervosa or bulimia nervosa
  • Drink large amounts of alcohol, use recreational drugs or abuse prescription medications - or suddenly stop substance abuse habits
Inform your healthcare provider right away if you have any of the following symptoms, especially if they are new, worsening, or worry you:
  • Attempts to commit suicide
  • Acting aggressive or violent
  • New or worsening depression
  • Feeling agitated, restless, angry, or irritable
  • An increase in activity or talking more than what is normal for you
  • Acting on dangerous impulses
  • Thoughts about suicide or dying
  • New or worsening anxiety or panic attacks
  • Trouble sleeping
  • Other unusual changes in behavior or mood
Bupropion ER XL may cause serious eye problems including a sudden decrease in vision with or without eye pain and redness, or a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma). These eye problems are rare, but can lead to permanent loss of vision if not treated. You may want to undergo an eye examination to see if you are at risk and get preventative treatment if you are.
Should you notice any new eye symptoms, including any new problems with your vision, immediately discontinue use of bupropion ER XL and seek urgent in-person evaluation. Please also message your provider team as soon as you are able.
Before taking bupropion ER XL, inform your healthcare provider and pharmacist about all prescription and over-the-counter medications you are taking or plan to take, including supplements. This includes medications to treat migraines and psychiatric disorders (including other antidepressants or amphetamines). Reporting all medication and supplement use is necessary to avoid a potentially life-threatening condition called serotonin syndrome; report aspirin, other NSAID pain relievers, or other blood thinners because they may increase the risk of bleeding.
Inform your healthcare provider immediately if you:
  • Become severely ill and have some or all of these symptoms: agitation, hallucinations, coma, or other changes in mental status; coordination problems or muscle twitching (overactive reflexes); fast, abnormal or racing heartbeat, high or low blood pressure; chest pain or pressure and shortness of breath; sweating or fever; nausea, vomiting, or diarrhea; muscle tightness, as these may be the symptoms of a life-threatening condition called serotonin syndrome
  • Have a rash, hives, swelling, or trouble breathing as these may be the symptoms of an allergic reaction
  • Have seizures or convulsions
  • Have any increased or unusual bruising or bleeding, especially if you take the blood thinner warfarin (Coumadin®, Jantoven®), a non-steroidal anti-inflammatory drug (NSAID), or aspirin
  • Have a headache; weakness or feeling unsteady; confusion, problems concentrating, thinking, or remembering, as these may be the symptoms of low salt (sodium) levels in the blood (hyponatremia). Elderly people may be at greater risk for this
  • Are pregnant, plan to become pregnant, or are breastfeeding
Do not stop daily bupropion ER XL without first talking to your healthcare provider. Stopping bupropion ER XL abruptly may sometimes cause discontinuation symptoms, including anxiety, irritability, high or low mood, and feeling restless or sleepy. Discontinuation symptoms are less common with bupropion than with other antidepressants.
Bupropion ER XL rarely causes sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how bupropion ER XL affects you. Most people find it makes them more alert.
Drinking alcohol on a regular basis while taking bupropion ER XL is not recommended. Occasional, moderate use appears to be safe.
During treatment with this medication, common side effects of this medication may go away as your body adjusts to the medication. The most common side effects in adults treated with bupropion XL include:
  • Constipation
  • Mild diarrhea
  • Nausea and vomiting
  • Decrease in appetite
  • Dizziness
  • Increased sweating
  • Weight loss
  • Headache
  • Dry Mouth
  • Trouble sleeping
  • Sleepiness
Swallow the tablet whole. Do not break, crush or chew it. For extended-release tablets, the tablet shell may be in your stool. This is normal and not cause for concern.
If you miss a dose of this medicine, do not take an extra tablet to make up for the dose you forgot. Wait and take your next dose at your regular time the next day. Do not double dose.

Important Safety Information

The information below includes important safety information about buspirone, which is the generic version of the brand name drug BuSpar®. Buspirone is a prescription medication used for the treatment of generalized anxiety disorder (GAD) or the short-term relief of symptoms of anxiety and can be used off-label to augment treatment for unipolar depression. Read this information before you begin taking buspirone. You must notify your healthcare provider if you start or stop taking buspirone.

Do not take buspirone if you:

  • Are allergic to buspirone, or any of the ingredients in buspirone
  • Have severe liver or kidney problems
  • Have benzodiazepine dependence
  • Take St John’s Wort or 5-Hydroxytryptophan (5-HTP)
  • Take any medicines for Parkinson’s Disease or depression called monoamine oxidase inhibitors (MAOI), or if you have stopped taking an MAOI in the last 14 days as they may cause a dangerous increase in blood pressure. MAOIs include, but are not limited to:
    • isocarboxazid
    • phenelzine
    • rasagiline
    • selegiline
    • tranylcypromine
  • Take other medication that may cause an increase in serotonin levels, such as
    • linezolid
    • methylene blue
    • tryptophan

Before taking buspirone, inform your healthcare provider and pharmacist about all prescription medications you are taking or plan to take, including those to treat Parkinson’s Disease or psychiatric disorders (including antidepressants or amphetamines) to avoid a potentially life-threatening condition called Serotonin Syndrome or a dangerous increase in blood pressure. Inform your healthcare provider about any over-the-counter medications, vitamins, and natural supplements, such as St. John’s Wort, that you are taking or plan to take to help avoid potentially dangerous drug-drug interactions. Be sure to mention to your prescriber if you drink grapefruit juice or eat grapefruit regularly.

Inform your healthcare provider immediately if you:

  • Become severely ill and have some or all of these symptoms: agitation, hallucinations, coma, or other changes in mental status; coordination problems or muscle twitching (overactive reflexes); racing heartbeat, high or low blood pressure; sweating or fever; nausea, vomiting, or diarrhea; muscle tightness, as these may be the symptoms of a life-threatening condition called Serotonin Syndrome
  • Develop restlessness or an inability to remain still, involuntary movements, hostility, or depression
  • Have a rash, hives, swelling, or trouble breathing as these may be the symptoms of an allergic reaction
  • Are pregnant, plan to become pregnant, or are breastfeeding

Do not stop daily buspirone without first talking to your healthcare provider. Abruptly stopping can cause withdrawal symptoms including: vomiting, irritability, dizziness, headaches, sensation of tingling skin, or trouble sleeping.

Until you experience how this medication affects you, do not drive a car, operate potentially dangerous machinery, or perform other dangerous activities.

You should take buspirone consistently, either always with or always without food.

During your treatment with buspirone, avoid drinking large amounts of grapefruit juice.

Avoid drinking alcohol while taking buspirone.

The most common side effects in adults treated with buspirone include:

  • Dizziness
  • Drowsiness
  • Diarrhea
  • Nausea
  • Headache
  • Insomnia
  • Mild congestion
  • A very rare but serious side effect that may occur with buspirone therapy is serotonin syndrome. The symptoms of serotonin syndrome include, but are not limited to, a change in mental status, trouble speaking or swallowing, excessive sweating, tremors, involuntary muscle contractions, and increased body temperature. Seek emergent medical care if you are experiencing any of these symptoms as they could be a sign of a life-threatening condition.

If you miss a dose of buspirone, take it as soon as you remember. However, if it is almost time for your next dose, then skip the missed dose and continue your regular dosing schedule. Do not double your next dose or take more than what is prescribed.

Important Safety Information

The information below includes important safety information about citalopram, which is the generic version of the brand name drug Celexa. Read this information before you begin taking citalopram. You must notify your healthcare provider if you start or stop taking citalopram.
Citalopram is a prescription medicine used to treat depression. Citalopram can be used off-label to treat: obsessive-compulsive disorder, panic disorder (panic attacks), social phobia (also known as social anxiety disorder), posttraumatic stress disorder, eating disorders, premenstrual dysphoric disorder, and alcohol dependence.

WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Citalopram and other antidepressant medicines may increase suicidal thoughts or actions, especially in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. If you are experiencing a mental health crisis, please call or text 988 to be connected with help, or go to your nearest hospital emergency department. Pay particular attention to such changes when citalopram is started or when the dose is changed.

Do not take citalopram (generic Celexa) if you:
  • are allergic to citalopram, or any of the ingredients in Citalopram
  • Take any medication for Parkinson’s Disease or depression called monoamine oxidase inhibitors (MAOI), or if you have stopped taking an MAOI in the last 14 days as they may cause a dangerous increase in blood pressure. MAOIs include, but are not limited to: isocarboxazid, phenelzine, rasagiline, selegiline, tranylcypromine
  • Take St John’s Wort or 5-Hydroxytryptophan (5-HTP)
  • are on methadone
  • are drinking large amounts of alcohol
  • are using or abusing recreation drugs or prescription medications
Citalopram can cause serious side effects. Rarely reported side effects include:
  • increased bleeding (gums, unexplained bruising)
  • low sodium blood levels (symptoms may include headache, weakness and difficulty remembering or concentrating)
  • teeth grinding
  • seizure
  • angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye)
  • QT prolongation and ventricular arrhythmia including Torsades de Pointes (changes in the electrical activity of your heart; symptoms may include fast, slow or irregular heartbeat, shortness of breath, and dizziness or fainting)
  • serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death)
Before you take citalopram, tell your healthcare provider if you: have thoughts of suicide or harming yourself have a history of psychiatric or medical problems, including bipolar disorder have taken any medication in the past for your condition, whether effective or not have suffered adverse or side effects from previous medication therapies drink alcohol or use/abuse recreational or prescription drugs are pregnant, plan to become pregnant, or are breastfeeding
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and recreational drugs.
Citalopram may affect the way other medicines work, and other medicines may affect the way citalopram works, causing side effects. Especially tell your healthcare provider if you take any of the following:
  • Aspirin or nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen, celecoxib, diclofenac)
  • Any other serotonergic medications including: trazodone, migraine medications (triptans), pain medications (tramadol), antibiotic linezolid, amphetamines
  • Warfarin or other anticoagulant therapy
  • certain antiarrhythmics: quinidine (Quinidex Extentabs®, Quinaglute®, Quinalan®), procainamide (Procanbid®, Pronestyl®, Pronestyl-SR®), amiodarone (Cordarone®, Pacerone®), sotalol (Betapace®, Sorine®)
  • certain antipsychotics: chlorpromazine (Thorazine®), thioridazine (Mellaril®)
  • certain antibiotics: gatifloxacin (Tequin®), moxifloxacin (Avelox®)
  • methadone
During treatment with this medication, common side effects of this medication may go away as your body adjusts to the medication. The most common side effects of citalopram include: Mild diarrhea, constipation, nausea, vomiting, upset stomach, dry mouth, loss of appetite, weight loss, sweating, headache, dizziness, yawning, nervousness, tremor, weakness, pharyngitis, sexual side effects (such as erectile dysfunction, ejaculation disorder, or lowered interest in sex), unusual dreams, fatigue or feeling sleepy, and trouble sleeping.
If you miss a dose of citalopram, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
Do not abruptly stop taking citalopram even when you feel better. Abruptly stopping can cause withdrawal symptoms including: vomiting, irritability, dizziness, headaches, sensation of tingling skin, or nightmares.
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.
Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.
If you no longer need your medication, the best way to dispose of most types of old, unused, unwanted, or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately. You can use the DEA DIVERSION CONTROL DIVISION LOOKUP to find your nearest drug disposal site.
If no drug take back sites, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can follow these simple steps to dispose of most medicines in your trash at home:
  • Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;
  • Place the mixture in a container such as a sealed plastic bag;
  • Throw away the container in your trash at home; and
  • Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.

Important Safety Information

The information below includes important safety information about duloxetine, which is the generic version of the brand name drug Cymbalta. Read this information before you begin taking duloxetine. You must notify your healthcare provider if you start or stop taking duloxetine.
Duloxetine is a prescription medicine used to treat major depressive disorder (MDD), generalized anxiety disorder (GAD), diabetic peripheral neuropathic pain (DPNP), fibromyalgia, and chronic musculoskeletal pain.

WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Duloxetine and other antidepressant medicines may increase suicidal thoughts or actions, especially in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. If you are experiencing a mental health crisis, please call or text 988 to be connected with help, or go to your nearest hospital emergency department. Pay particular attention to such changes when duloxetine is started or when the dose is changed.

Do not take duloxetine if you:
  • are allergic to duloxetine, or any of the ingredients in duloxetine
  • Take any medication for Parkinson’s Disease or depression called monoamine oxidase inhibitors (MAOI), or if you have stopped taking an MAOI in the last 14 days as they may cause a dangerous increase in blood pressure. MAOIs include, but are not limited to: isocarboxazid, phenelzine, rasagiline, selegiline, tranylcypromine
  • Take St John’s Wort or 5-Hydroxytryptophan (5-HTP)
  • have a medical history of a liver disease
  • are drinking large amounts of alcohol
  • are using or abusing recreation drugs or prescription medications
Duloxetine can cause serious side effects. Rarely reported side effects include:
  • liver failure, sometimes fatal
  • orthostatic hypotension,a drop in blood pressure when standing or getting up from sleep
  • increased risk of bleeding
  • increased heart rate
  • irregular menstrual cycle
  • frequency of urination or difficulty urinating
  • angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye)
  • serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death)
  • hypertensive crisis
  • Stevens-Johnson Syndrome (rash)
  • pancreatitis
Before you take duloxetine, tell your healthcare provider if you:
  • Have high blood pressure
  • have thoughts of suicide or harming yourself
  • have a history of psychiatric or medical problems, including bipolar disorder
  • have taken any medication in the past for your condition, whether effective or not
  • have suffered adverse or side effects from previous medication therapies
  • drink alcohol or use/abuse recreational or prescription drugs
  • are pregnant, plan to become pregnant, or are breastfeeding
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and recreational drugs.
Duloxetine may affect the way other medicines work, and other medicines may affect the way duloxetine works, causing side effects. Especially tell your healthcare provider if you take any of the following:
  • Aspirin or nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen, celecoxib, diclofenac)
  • Any other serotonergic medications including: trazodone, migraine medications (triptans), pain medications (tramadol), antibiotic linezolid, amphetamines
  • Warfarin or other anticoagulants
  • cimetidine (Tagamet®)
  • ciprofloxacin (Cipro®)
During treatment with this medication, common side effects of this medication may go away as your body adjusts to the medication. The most common side effects of duloxetine: headache, dizziness, nausea, vomiting, upset stomach, diarrhea, dry mouth, constipation, loss of appetite, weight loss, increased sweating, feeling nervous, restless, fatigued, unusual dreams, sleepiness or trouble sleeping (insomnia). Sexual side effects (such as problems with orgasm or ejaculatory delay) or increased blood pressure may not improve over time.
Swallow the capsule whole. Do not break, crush or chew it. If you miss a dose of duloxetine take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
Do not abruptly stop taking duloxetine even when you feel better. Abruptly stopping can cause withdrawal symptoms including: vomiting, irritability, dizziness, headaches, sensation of tingling skin, or nightmares.
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.
Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.
If you no longer need your medication, the best way to dispose of most types of old, unused, unwanted, or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately. You can use the DEA DIVERSION CONTROL DIVISION LOOKUP to find your nearest drug disposal site.
If no drug take back sites, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can follow these simple steps to dispose of most medicines in your trash at home:
  • Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;
  • Place the mixture in a container such as a sealed plastic bag;
  • Throw away the container in your trash at home; and
  • Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.

Important Safety Information

The information below includes important safety information about escitalopram, which is the generic version of the brand name drug Lexapro. Read this information before you begin taking escitalopram. You must notify your healthcare provider if you start or stop taking escitalopram.
Escitalopram is a prescription medicine used to treat major depressive disorder (MDD) and generalized anxiety disorder (GAD). Escitalopram may also be helpful when prescribed “off-label” for obsessive compulsive disorder (OCD), panic disorder, and premenstrual dysphoric disorder.

WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Escitalopram and other antidepressant medicines may increase suicidal thoughts or actions, especially in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. If you are experiencing a mental health crisis, please call or text 988 to be connected with help, or go to your nearest hospital emergency department. Pay particular attention to such changes when escitalopram is started or when the dose is changed.

Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.
Do not take Escitalopram if you:
  • are allergic to escitalopram, or any of the ingredients in escitalopram
  • Take any medication for Parkinson’s Disease or depression called monoamine oxidase inhibitors (MAOI), or if you have stopped taking an MAOI in the last 14 days as they may cause a dangerous increase in blood pressure. MAOIs include, but are not limited to: isocarboxazid, phenelzine, rasagiline, selegiline, tranylcypromine
  • Take St John’s Wort or 5-Hydroxytryptophan (5-HTP)
  • also take pimozide (Orap) or citalopram (Celexa)
  • are drinking large amounts of alcohol
  • are using or abusing recreation drugs or prescription medications
Escitalopram can cause serious side effects. Rarely reported side effects include:
  • increased bleeding (gums)
  • low sodium blood levels (symptoms may include headache, weakness and difficulty remembering or concentrating)
  • teeth grinding
  • seizure
  • angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye)
  • QT prolongation and ventricular arrhythmia including Torsades de Pointes (changes in the electrical activity of your heart; symptoms may include fast, slow or irregular heartbeat, shortness of breath, and dizziness or fainting)
  • serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death)
Before you take escitalopram, tell your healthcare provider if you:
  • have thoughts of suicide or harming yourself
  • have a history of psychiatric or medical problems, including bipolar disorder
  • have taken any medication in the past for your condition, whether effective or not
  • have suffered adverse or side effects from previous medication therapies
  • drink alcohol or use/abuse recreational or prescription drugs
  • are pregnant, plan to become pregnant, or are breastfeeding
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and recreational drugs.
Escitalopram may affect the way other medicines work, and other medicines may affect the way escitalopram works, causing side effects. Especially tell your healthcare provider if you take any of the following:
  • Aspirin or nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen, celecoxib, diclofenac)
  • Warfarin or other anticoagulants
  • Any other serotonergic medications including: trazodone, migraine medications (triptans), pain medications (tramadol), antibiotic linezolid, amphetamines
During treatment with this medication, common side effects of this medication may go away as your body adjusts to the medication. The most common side effects of escitalopram include: headache, dizziness, nausea, vomiting, diarrhea, constipation, upset stomach, nose or throat irritation, dry mouth, loss of appetite, weight loss, increased sweating, yawning, feeling nervous, restless, fatigued, tremor, unusual dreams, sleepiness or having trouble sleeping (insomnia). Sexual side effects, such as problems with orgasm or ejaculatory delay, often do not diminish over time.
If you miss a dose of escitalopram, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
Do not abruptly stop taking escitalopram even when you feel better. Abruptly stopping can cause withdrawal symptoms including: vomiting, irritability, dizziness, headaches, sensation of tingling skin, or nightmares.
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.
If you no longer need your medication, the best way to dispose of most types of old, unused, unwanted, or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately. You can use the DEA DIVERSION CONTROL DIVISION LOOKUP to find your nearest drug disposal site.
If no drug take back sites, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can follow these simple steps to dispose of most medicines in your trash at home:
  • Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;
  • Place the mixture in a container such as a sealed plastic bag;
  • Throw away the container in your trash at home; and
  • Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.

Important Safety Information

The information below includes important safety information about fluoxetine, which is the generic version of the brand name drug Prozac. Read this information before you begin taking fluoxetine. You must notify your healthcare provider if you start or stop taking fluoxetine.
Fluoxetine is a prescription medicine used to treat major depressive disorder (MDD), obsessive compulsive disorder (OCD), panic disorder, bulimia nervosa, and premenstrual dysphoric disorder (PMDD). Fluoxetine may also be helpful when prescribed “off-label” for body dysmorphic disorder, dysthymia, or posttraumatic stress disorder (PTSD).

WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Fluoxetine and other antidepressant medicines may increase suicidal thoughts or actions, especially in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. If you are experiencing a mental health crisis, please call or text 988 to be connected with help, or go to your nearest hospital emergency department. Pay particular attention to such changes when fluoxetine is started or when the dose is changed.

Do not take Fluoxetine if you:
  • are allergic to fluoxetine, or any of the ingredients in fluoxetine
  • Take any medication for Parkinson’s Disease or depression called monoamine oxidase inhibitors (MAOI), or if you have stopped taking an MAOI in the last 14 days as they may cause a dangerous increase in blood pressure. MAOIs include, but are not limited to: isocarboxazid, phenelzine, rasagiline, selegiline, tranylcypromine
  • Take St John’s Wort or 5-Hydroxytryptophan (5-HTP)
  • taking tamoxifen
  • are drinking large amounts of alcohol
  • are using or abusing recreation drugs or prescription medications
Fluoxetine can cause serious side effects. Rarely reported side effects include:
  • low sodium blood levels (symptoms may include headache, weakness, difficulty remembering or concentrating, feeling confused, seizures, change in balance, a significant weight gain or loss)
  • angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye)
  • serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death)
  • increased bleeding (gums)
  • Seizures
  • Dizziness
  • Slow heartbeat
  • Menstrual changes
  • Passing urine more often
  • Trouble controlling body movements
  • Erection that lasts more than 4 hours
  • teeth grinding
  • QT prolongation and ventricular arrhythmia including Torsades de Pointes (changes in the electrical activity of your heart; symptoms may include fast, slow or irregular heartbeat, shortness of breath, and dizziness or fainting)
  • increased risk of bleeding events when combined with use of aspirin, nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen), warfarin, and other anticoagulants
Before you take fluoxetine, tell your healthcare provider if you:
  • have thoughts of suicide or harming yourself
  • have a history of psychiatric or medical problems, including bipolar disorder
  • have taken any medication in the past for your condition, whether effective or not
  • have suffered adverse or side effects from previous medication therapies
  • drink alcohol or use/abuse recreational or prescription drugs
  • are pregnant, plan to become pregnant, or are breastfeeding
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and recreational drugs.
Fluoxetine may affect the way other medicines work, and other medicines may affect the way fluoxetine works, causing side effects. Especially tell your healthcare provider if you take any of the following:
  • Aspirin or nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen, celecoxib, diclofenac)
  • Warfarin or other anticoagulants
  • Any other serotonergic medications including: trazodone, migraine medications (triptans), pain medications (tramadol), antibiotic linezolid, amphetamines
  • anticonvulsants (phenytoin, carbamazepine)
  • antipsychotics (haloperidol, aripiprazole)
  • atomoxetine
  • tricyclic antidepressants (imipramine, desipramine)
  • beta blockers (metoprolol, propranolol)
  • tamoxifen
During treatment with this medication, the side effects of this medication may go away as your body adjusts to the medication. The most common side effects of fluoxetine include: headache, nausea, vomiting, diarrhea, constipation, upset stomach, decreased appetite, flu-like symptoms, dry mouth, nose or throat irritation, increased sweating, feeling nervous, restlessness, shakiness, fatigue, yawning, hot flashes, unusual dreams, sleepiness or having trouble sleeping (insomnia). Sexual side effects, such as problems with orgasm or ejaculatory delay often do not diminish over time.
The delayed release form should be swallowed whole. Do not break, crush or chew it.
If you miss a dose of fluoxetine that you take daily, take it as soon as you remember, unless it is closer to the time of your next dose. If you take fluoxetine once weekly, take it as soon as possible, then go back to your regular schedule the next week. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
Do not stop taking fluoxetine, even when you feel better. Abruptly stopping can cause withdrawal symptoms including: vomiting, irritability, dizziness, headaches, sensation of tingling skin, or nightmares.
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.
Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.
If you no longer need your medication, the best way to dispose of most types of old, unused, unwanted, or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately. You can use the DEA DIVERSION CONTROL DIVISION LOOKUP to find your nearest drug disposal site.
If no drug take back sites, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can follow these simple steps to dispose of most medicines in your trash at home:
  • Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;
  • Place the mixture in a container such as a sealed plastic bag;
  • Throw away the container in your trash at home; and
  • Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging

Important Safety Information

The information below includes important safety information about paroxetine, which is the generic version of the brand name drug Paxil. Read this information before you begin taking paroxetine. You must notify your healthcare provider if you start or stop taking paroxetine.
Paroxetine is a prescription medicine used to treat major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder (social phobia), panic disorder, obsessive compulsive disorder (OCD), posttraumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), and vasomotor symptoms of menopause. Paroxetine is also used off-label to treat premature ejaculation.

WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Paroxetine and other antidepressant medicines may increase suicidal thoughts or actions, especially in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. If you are experiencing a mental health crisis, please call or text 988 to be connected with help, or go to your nearest hospital emergency department. Pay particular attention to such changes when paroxetine is started or when the dose is changed.

Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.
Do not take Paroxetine if you:
  • are allergic to paroxetine, or any of the ingredients in Fluoxetine
  • Take any medication for Parkinson’s Disease or depression called monoamine oxidase inhibitors (MAOI), or if you have stopped taking an MAOI in the last 14 days as they may cause a dangerous increase in blood pressure. MAOIs include, but are not limited to: isocarboxazid, phenelzine, rasagiline, selegiline, tranylcypromine
  • Take St John’s Wort or 5-Hydroxytryptophan (5-HTP)
  • taking thioridazine
  • taking tamoxifen
  • taking pimozide
  • are drinking large amounts of alcohol
  • are abusing recreation drugs or prescription medications
  • Are pregnant, plan to become pregnant, or are breastfeeding
Paroxetine can cause serious side effects. Rarely reported side effects include:
  • low sodium blood levels (symptoms may include headache, weakness and difficulty remembering or concentrating)
  • teeth grinding
  • angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye)
  • serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death)
  • seizures
  • increased risk of bleeding events when combined with use of aspirin, nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen), warfarin, and other anticoagulants
Before you take paroxetine, tell your healthcare provider if you:
  • have thoughts of suicide or harming yourself
  • have a history of psychiatric or medical problems, including bipolar disorder
  • have taken any medication in the past for your condition, whether effective or not
  • have suffered adverse or side effects from previous medication therapies
  • drink alcohol or use/abuse recreational or prescription drugs
  • are pregnant, plan to become pregnant, or are breastfeeding
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and recreational drugs.
Paroxetine may affect the way other medicines work, and other medicines may affect the way paroxetine works, causing side effects. Especially tell your healthcare provider if you take any of the following:
  • Aspirin or nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen, celecoxib, diclofenac)
  • Any other serotonergic medications including: trazodone, migraine medications (triptans), pain medications (tramadol), antibiotic linezolid, amphetamines
  • atomoxetine
  • antipsychotics (aripiprazole, risperidone)
  • Warfarin or other anticoagulants
  • cardiac medications (propafenone, metoprolol, propranolol)
  • tricyclic antidepressants (desipramine, imipramine)
During treatment with this medication, common side effects of this medication may go away as your body adjusts to the medication. The most common side effects of paroxetine: Headache, nausea, constipation, diarrhea, dry mouth, loss of appetite, weight loss, increased sweating, dizziness, feeling nervous, restless, fatigued, yawning, tremor, unusual dreams, sleepiness, ,or trouble sleeping (insomnia). Sexual side effects, such as erectile dysfunction, lowered interest in sex, and problems with orgasm or ejaculatory delay often do not diminish over time.
The controlled release form should be swallowed whole. Do not break, crush or chew it.
If you miss a dose of paroxetine, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
Do not stop taking paroxetine, even when you feel better. Abruptly stopping can cause withdrawal symptoms including: nausea, sweating, dysphoric mood, irritability, agitation, dizziness, sensory disturbances as electric shock sensations, tremor, anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, ringing in the ears, and seizures.
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.
If you no longer need your medication, the best way to dispose of most types of old, unused, unwanted, or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately. You can use the DEA DIVERSION CONTROL DIVISION LOOKUP to find your nearest drug disposal site.
If no drug take back sites, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can follow these simple steps to dispose of most medicines in your trash at home:
  • Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;
  • Place the mixture in a container such as a sealed plastic bag;
  • Throw away the container in your trash at home; and
  • Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.

Important Safety Information

The information below includes important safety information about sertraline, which is the generic version of the brand name drug Zoloft. Read this information before you begin taking sertraline. You must notify your healthcare provider if you start or stop taking sertraline.
Sertraline is a prescription medicine used to treat major depressive disorder (MDD), posttraumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), panic disorder, and social anxiety disorder. Sertraline may also be helpful when prescribed “off-label” for binge-eating disorder, bulimia nervosa, and generalized anxiety disorder (GAD).

WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Sertraline and other antidepressant medicines may increase suicidal thoughts or actions, especially in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. If you are experiencing a mental health crisis, please call or text 988 to be connected with help, or go to your nearest hospital emergency department. Pay particular attention to such changes when sertraline is started or when the dose is changed.

Do not take sertraline if you:
  • are allergic to sertraline, or any of the ingredients in sertraline
  • Take any medication for Parkinson’s Disease or depression called monoamine oxidase inhibitors (MAOI), or if you have stopped taking an MAOI in the last 14 days as they may cause a dangerous increase in blood pressure. MAOIs include, but are not limited to: isocarboxazid, phenelzine, rasagiline, selegiline, tranylcypromine
  • Take St John’s Wort or 5-Hydroxytryptophan (5-HTP)
  • are taking pimozide
  • are drinking large amounts of alcohol
  • are abusing recreation drugs or prescription medications
Sertraline can cause serious side effects. Rarely reported side effects include:
  • low sodium blood levels (symptoms may include headache, weakness and difficulty remembering or concentrating)
  • teeth grinding
  • angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye)
  • serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death)
  • seizure
  • increased risk of bleeding events when combined with use of aspirin, nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen), warfarin, and other anticoagulants
Before you take sertraline, tell your healthcare provider if you:
  • have thoughts of suicide or harming yourself
  • have a history of psychiatric or medical problems, including bipolar disorder
  • have taken any medication in the past for your condition, whether effective or not
  • have suffered adverse or side effects from previous medication therapies
  • drink alcohol or use/abuse recreational or prescription drugs
  • are pregnant, plan to become pregnant, or are breastfeeding
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and recreational drugs.
Sertraline may affect the way other medicines work, and other medicines may affect the way sertraline works, causing side effects. Especially tell your healthcare provider if you take any of the following:
  • Any other serotonergic medications including: trazodone, migraine medications (triptans), pain medications (tramadol), antibiotic linezolid, amphetamines
  • Aspirin or nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen, celecoxib, diclofenac)
  • Warfarin or other anticoagulants
During treatment with this medication, the side effects of this medication may go away over the first week or two as your body adjusts to the medication. The most common side effects of sertraline: Headache, dizziness, loss of appetite, weight loss, nausea, vomiting, diarrhea, dry mouth, increased sweating, yawning, tremor, feeling nervous, restless, fatigue, unusual dreams, sleepiness or having trouble sleeping (insomnia). Sexual side effects, such as problems with orgasm or ejaculatory delay often do not diminish over time.
If you miss a dose of sertraline, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
Do not stop taking sertraline abruptly, even when you feel better. Abruptly stopping can cause withdrawal symptoms including: irritability, nausea, feeling dizzy, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling sensation on the skin).
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.
Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.
If needed, the best way to dispose of most types of old, unused, unwanted, or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately. You can use the DEA DIVERSION CONTROL DIVISION LOOKUP to find your nearest drug disposal site.
If you no longer need your medication, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can follow these simple steps to dispose of most medicines in your trash at home:
  • Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;
  • Place the mixture in a container such as a sealed plastic bag;
  • Throw away the container in your trash at home; and
  • Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.

Important Safety Information

The information below includes important safety information about venlafaxine ER, which is the generic version of the brand name drug Effexor XL. Read this information before you begin taking venlafaxine ER. You must notify your healthcare provider if you start or stop taking venlafaxine ER.
Venlafaxine ER is a prescription medicine used to treat major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder (social phobia. Extended release tablets should be swallowed whole. Do not break, crush or chew it. Extended release capsules: swallow whole or sprinkle onto food, such as applesauce or pudding and eat immediately.

WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Venlafaxine ER and other antidepressant medicines may increase suicidal thoughts or actions, especially in some people 24 years of age and younger within the first few months of treatment or when the dose is changed. If you are experiencing a mental health crisis, please call or text 988 to be connected with help, or go to your nearest hospital emergency department. Pay particular attention to such changes when venlafaxine ER is started or when the dose is changed.

Do not take venlafaxine if you:
  • are allergic to venlafaxine, or any of the ingredients in venlafaxine ER
  • Take any medication for Parkinson’s Disease or depression called monoamine oxidase inhibitors (MAOI), or if you have stopped taking an MAOI in the last 14 days as they may cause a dangerous increase in blood pressure. MAOIs include, but are not limited to: isocarboxazid, phenelzine, rasagiline, selegiline, tranylcypromine
  • Take St John’s Wort or 5-Hydroxytryptophan (5-HTP)
  • are drinking large amounts of alcohol
  • are using or abusing recreation drugs or prescription medications
Venlafaxine ER can cause serious side effects. Rarely reported side effects include:
  • increased heart rate, low blood pressure
  • increased salivation
  • irregular menstrual cycle
  • increased frequency of urination, difficulty urinating
  • changes in taste
  • low sodium (symptoms of low sodium levels may include headache, weakness, difficulty concentrating and remembering)
  • teeth grinding
  • angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye)
  • serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death)
  • increased risk of bleeding events when combined with use of aspirin, nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen), warfarin, and other anticoagulants
Before you take venlafaxine ER, tell your healthcare provider if you:
  • have thoughts of suicide or harming yourself
  • have a history of psychiatric or medical problems, including bipolar disorder
  • have taken any medication in the past for your condition, whether effective or not
  • have suffered adverse or side effects from previous medication therapies
  • drink alcohol or use/abuse recreational or prescription drugs
  • are pregnant, plan to become pregnant, or are breastfeeding
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and recreational drugs.
Venlafaxine ER may affect the way other medicines work, and other medicines may affect the way venlafaxine ER works, causing side effects. Especially tell your healthcare provider if you take any of the following:
  • Any other serotonergic medications including: trazodone, migraine medications (triptans), pain medications (tramadol), antibiotic linezolid, amphetamines
  • Aspirin or nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen, celecoxib, diclofenac)
  • Warfarin or other anticoagulants
During treatment with this medication, the side effects of this medication may go away over the first one to two weeks your body adjusts to the medication. The most common side effects of venlafaxine include: headache, dizziness, shakiness, nausea, diarrhea, constipation, gas, upset stomach, dry mouth, weight loss, loss of appetite, increased sweating, feeling nervous, anxiety, restlessness, fatigue, yawning, unusual dreams, sleepiness or having trouble sleeping (insomnia). Sexual side effects, such as problems with orgasm or ejaculatory delay, or increased blood pressure often do not improve over time.
If you miss a dose of venlafaxine ER, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
Do not stop taking venlafaxine ER abruptly, even when you feel better. Abruptly stopping can cause withdrawal symptoms including: irritability, nausea, feeling dizzy, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling sensation on the skin).
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.
Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or healthcare professional. All patients being treated with antidepressants for any indication should watch for and notify their healthcare provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.
If you no longer need your medication, the best way to dispose of most types of old, unused, unwanted, or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately. You can use the DEA DIVERSION CONTROL DIVISION LOOKUP to find your nearest drug disposal site.
If no drug take back sites, locations, or programs are available in your area, and there are no specific disposal instructions (such as flushing) in the medication guide or package insert, you can follow these simple steps to dispose of most medicines in your trash at home:
  • Mix medicines (liquid or pills; do not crush tablets or capsules) with an unappealing substance such as dirt, cat litter, or used coffee grounds;
  • Place the mixture in a container such as a sealed plastic bag;
  • Throw away the container in your trash at home; and
  • Delete all personal information on the prescription label of empty medicine bottles or medicine packaging, then trash or recycle the empty bottle or packaging.

* On average. Actual appointment times vary by state and individual patient. Between 5/30/22 and 5/29/23, providers providing psychiatric care on the Hims & Hers platform were scheduled for appointments within 12 to 48 hours after intake form submission.
* Subscription required. For a three-month subscription, after 20% off your treatment plan for the first three months, price is $49/month ($117 for first order, $147 billed quarterly thereafter). Discount also applies to 6 and 12 month subscriptions. For a monthly subscription, price is $85/month. Subscription automatically renews unless you cancel at least 7 days before renewal is processed. Prescription products require an online consultation with a healthcare provider who will determine if a prescription is appropriate. Restrictions apply. See website for full details and important safety information.
* Controlled substances, including amphetamines (such as Adderall) or benzodiazepines (such as Xanax and Valium) are not available through our platform.

Find relief for your symptoms

Learn about your symptom score through clinically-backed assessments